Opening Doors video transcript

Opening titles

Opening Doors: Trauma Informed Practice for the Workforce

NHS Education for Scotland in partnership with Scottish Government

This animation was created to support the development of a trauma informed workforce in Scotland. It highlights the ways that traumatic experiences like sexual abuse and domestic abuse can affect people.

Some people may find this distressing, and advice about sources of support is available at the end of the animation.

Everyone has a role in creating opportunities and life chances for people affected by trauma and adversity.

Animation

We see a young girl, looking fearful after an adult man enters her bedroom.

Whenever Mum went away, he would come into my room.

He said I made him do it and that it meant he loved me.

It always made me feel powerless, ashamed.

A young boy hides at the top of the stairs, looking at his watch. It is late.

I never knew when an argument would turn into a fight.

I was always scared, always on edge, always had to be ready to defend myself.

A middle-aged woman wistfully looks out of the window before being berated by a man aggressively pointing his finger.

My late husband was very controlling, always put me down, told me what to wear or cook.

He’d get angry if I didn’t do things right.

I had no choice or control. It made me feel useless.

I had no confidence in the end.

The young girl in her bedroom quivers as the shadow of a man looms over her.

We see her as an adult, looking anxious as a dentist stands over her to perform a procedure.

So I zoned out, pretended it wasn’t happening.

It’s so difficult to trust people now, I just freeze and float away in my head when I feel powerless…

As an adult, the young boy from the top of the stairs displays signs of anger in everyday situations.

Now I just I get angry a lot, feel like I want to fight.

Sometimes I worry I’m just like him.

The middle-aged woman, scared of husband, now shys away fearful from meeting new people.

I find it difficult to do things myself, and I get really nervous when I have to talk to new people.

I avoid them when I can.

All 3 trauma survivors now speak in one voice;

What we went through was traumatic. Because we were harmed, physically, emotionally and felt like we were in real danger.

Traumatic experiences can be things that happen once, a serious accident, or assault.

Or it can be where traumatic things keep happening, like physical or sexual childhood abuse, or domestic abuse. Or relationships where you can’t be yourself, where you’re put down or bullied.

It can make you feel powerless, trapped or betrayed. The sense of confusion, shame or fear can be overwhelming, especially if there is no-one you feel able to tell.

Even after it’s over, it’s harder to get on with life and feel safe.

We see a crowd of people from all walks of life as a narrator speaks;

Trauma is more common than most people think. Almost one in five adults has experienced physical or sexual abuse in their childhood. And more than a quarter of all women have experienced domestic abuse.

Some people recover after traumatic events, some people aren’t affected as much. Having good, safe, supportive relationships with other people can really help. But lots of people continue to be affected by trauma, sometimes long after it happened.

For most of us, traumatic or adverse childhood experiences like these affect our body’s response to stress, affecting our physical health as well as our mental health.

The impact of trauma can also make it harder for us to learn and to realise our full potential.

One of the most worrying things about the experience of trauma is that it can make us avoid people and places, even if they are there to help. Like doctors, teachers, social workers, carers, college, councils, community centres,employers, advisers…

Because most trauma experiences happen in relationships with other people, we can find it difficult to trust people, or feel safe. And sometimes the way we react to help ourselves feel safe pushes people away and makes it even harder to get the help we need.

It’s like our brains learned survival tricks to get us through the trauma at the time. Like ‘priming us for danger’. Making us run away. Shutting down when we feel upset.

Caption: Doing things differently

We see medical professionals interacting with their patients positively and with care.

Our 3 trauma survivors now talk directly to us;

It might look like we have a short fuse. Like we’re unfriendly. Or we’re just a bit absent. Anything – however small – that reminds us of that trauma can set off our own unique ‘trauma response’ to protect ourselves. Making us avoid the people and places that we need the most. Like you.

But there are things you can do to help me trust you enough so I feel safe, and I don’t shut down or avoid you.

You can offer me a different relationship, that doesn’t remind me of the one I had when I was a kid.

One where I feel safe, I feel empowered and I have choice and control over what happens to me.

One where we work together, and I can trust you. This is called being trauma informed in the way you work.

Being trauma informed means thinking about what will make me feel safe.

It might mean offering me choice over the sex of the person offering me care or support, especially if it involves intimate care or examinations.

The middle-aged woman who was fearful of her husband receives a telephone call from her care provider.

Unfortunately your usual care worker Heather is off sick. We’ll be sending someone else instead. Do you have any preferences about who comes instead?

Well, I’d feel more comfortable with someone I’ve met before. Most importantly I’d like a woman.

How about June? She’s worked with us for three years. If there’s anything you’d like her to do that Heather normally does, just ask…

The young woman meets with her dentist again, and speaks about her wishes;

Trauma informed means empowering me to have control and take an active role in what happens to me.

The dentist speaks to the young woman;

We know some people don’t like coming to the dentist, so is there anything that you’re worried about or scared of?

I can tell you each step I’m doing so there are no surprises if you’d like? If you need me to stop, how will you tell me?

The young man who suffers from anger related issues is in a shop waiting for service.

Trauma informed means helping me to trust you by being clear about what will happen, doing what you say you will do, when you said you would do it…

The service assistant speaks to the man;

Unfortunately our advisers are running about 30 minutes late. I’m so sorry about that. Are you able to stay? – or can we make another appointment for you?

We again see people from all walks of life who have suffered from trauma as the narrator speaks to the audience;

Many of us at work will have had our own experiences of trauma, in our own lives.

Or we might witness or hear about it in the course of our work.

So the same principles apply to all of us.

We all need to take care of ourselves by making sure we’re safe and connected to the people and activities that matter to us.

Can you think of anyone you've met or worked with recently that a trauma informed approach would have made a difference to?

Are there any trauma informed changes you might make that could make a difference?

The trauma survivors are now speaking as one as we see them interact positively with medical professionals.

So if you offer me safety and choice, if you collaborate with me and empower me and help me trust you, then you will help me work with you. Even if I only meet you once, even briefly, you can give me a different kind of relationship. One where I feel valued and valuable, connected, and safe.

And when that happens over and over again, with everyone that I meet, I can learn that it’s safe to make connections with people.

It is those connections that we all need to access life chances and reach our full potential.

As the animation ends, the 3 trauma survivors leave their respective medical appointments looking positively out into the world.